Premature ventricular complex site of origin and ablation outcomes in patients with prior myocardial infarction
Penela D. ; Teres C. ; Fernández-Armenta J. ; Aguinaga L. ; Tercedor L. ; Soto-Iglesias D. ; Jauregui, B. ; Ordóñez A. ; Acosta J. ; Bisbal F. ; Aceña M. ; Silva E. ; Chauca A. ; De Sensi F. ; Vatasescu R. ; Sánchez-Millán P. ; Carballo J. ; Mont L. ; Berruezo A.
Resumen: Background
Frequent premature ventricular complexes (PVCs) are common after a myocardial infarction (MI), but data on PVC ablation in this population are limited.
Objective
The purpose of this study was to analyze data on PVC ablation in post-MI patients.
Methods
Three hundred thirty-two patients with frequent PVCs and left ventricular (LV) dysfunction were prospectively studied. Data from 67 patients (20%; age 63 ± 10 years; 65 men [93%]) with previous MI were compared with the remaining 265 patients.
Results
PVCs in post-MI patients originate predominantly from the LV (92% LV vs 6% right ventricle [RV]; P <.001). The most frequent sites of origin (SOO) were MI scar in 23 patients (34%) and left ventricular outflow tract (LVOT) in 22 patients (33%). A papillary muscle origin was more frequent in post-MI patients (16% vs 4%; P = .001), whereas an RV outflow tract origin was less frequent (1% vs 33%; P <.001) compared to patients without MI. In post-MI patients, PVC burden decreased from 29% ± 12% at baseline to 4.6% ± 7% (P <.001); left ventricular ejection fraction (LVEF) improved from 33.6% ± 8% to 42% ± 10% (P <.001); and New York Heart Association functional class improved from 2.1 ± 0.7 to 1.4 ± 0.5 points (P <.001) at 12 months. Compared with the remaining 265 patients, there were no differences in acute ablation success (85% vs 85%; P = .45), complication rate (6% vs 6%; P = .41), or absolute improvement in LVEF (8.8 ± 10 vs 9.9 ± 11 absolute points; P = .38).
Conclusion
PVC ablation significantly improves cardiac function and functional status in post-MI patients. PVCs predominantly originate from MI scar and LVOT. A papillary muscle SOO was found to be strongly associated with previous MI.
Idioma: Inglés
DOI: 10.1016/j.hrthm.2020.07.037
Año: 2021
Publicado en: HEART RHYTHM 18, 1 (2021), 27 - 33
ISSN: 1547-5271
Factor impacto JCR: 6.779 (2021)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 36 / 143 = 0.252 (2021) - Q2 - T1
Factor impacto CITESCORE: 10.1 - Medicine (Q1)
Factor impacto SCIMAGO: 2.402 - Physiology (medical) (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Article (PostPrint)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
Exportado de SIDERAL (2026-02-04-13:13:46)
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Frequent premature ventricular complexes (PVCs) are common after a myocardial infarction (MI), but data on PVC ablation in this population are limited.
Objective
The purpose of this study was to analyze data on PVC ablation in post-MI patients.
Methods
Three hundred thirty-two patients with frequent PVCs and left ventricular (LV) dysfunction were prospectively studied. Data from 67 patients (20%; age 63 ± 10 years; 65 men [93%]) with previous MI were compared with the remaining 265 patients.
Results
PVCs in post-MI patients originate predominantly from the LV (92% LV vs 6% right ventricle [RV]; P <.001). The most frequent sites of origin (SOO) were MI scar in 23 patients (34%) and left ventricular outflow tract (LVOT) in 22 patients (33%). A papillary muscle origin was more frequent in post-MI patients (16% vs 4%; P = .001), whereas an RV outflow tract origin was less frequent (1% vs 33%; P <.001) compared to patients without MI. In post-MI patients, PVC burden decreased from 29% ± 12% at baseline to 4.6% ± 7% (P <.001); left ventricular ejection fraction (LVEF) improved from 33.6% ± 8% to 42% ± 10% (P <.001); and New York Heart Association functional class improved from 2.1 ± 0.7 to 1.4 ± 0.5 points (P <.001) at 12 months. Compared with the remaining 265 patients, there were no differences in acute ablation success (85% vs 85%; P = .45), complication rate (6% vs 6%; P = .41), or absolute improvement in LVEF (8.8 ± 10 vs 9.9 ± 11 absolute points; P = .38).
Conclusion
PVC ablation significantly improves cardiac function and functional status in post-MI patients. PVCs predominantly originate from MI scar and LVOT. A papillary muscle SOO was found to be strongly associated with previous MI.
Idioma: Inglés
DOI: 10.1016/j.hrthm.2020.07.037
Año: 2021
Publicado en: HEART RHYTHM 18, 1 (2021), 27 - 33
ISSN: 1547-5271
Factor impacto JCR: 6.779 (2021)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 36 / 143 = 0.252 (2021) - Q2 - T1
Factor impacto CITESCORE: 10.1 - Medicine (Q1)
Factor impacto SCIMAGO: 2.402 - Physiology (medical) (Q1) - Cardiology and Cardiovascular Medicine (Q1)
Tipo y forma: Article (PostPrint)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2026-02-04-13:13:46)
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Record created 2026-02-04, last modified 2026-02-04